Microembolic signals are associated with progression of arterial lesion in Moyamoya disease: A case report

Iguchi, Yasuyuki; Kimura, Kazumi; Tateishi, Youhei; Shibazaki, Kensaku; Iwanaga, Takeshi; Inoue, Takeshi

doi:10.1016/j.jns.2007.04.004

Cited by 11 publications

(6 citation statements)

References 9 publications

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“…Transcranial Doppler ultrasonography may provide additional information by detecting embolic signals,10 but it was not routinely performed in the present study. Several studies have reported arterial embolic events in patients with adult MMD 11 12. Despite these reports, there is no doubt that haemodynamic compromise is the principal mechanism of ischaemic stroke in MMD,13 which was confirmed in the present study.…”

Section: Discussionsupporting

confidence: 79%

Changing ischaemic lesion patterns in adult moyamoya disease

Kim

Lee

Roh

2008

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Discussionsupporting

confidence: 79%

Changing ischaemic lesion patterns in adult moyamoya disease

Kim

Lee

Roh

2008

Journal of Neurology, Neurosurgery & Psychiatry

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“…Our transcranial Doppler results are in line with previous case reports, suggesting that microembolism is associated with disease progression and development of brain infarction in patients with MMD. 9,16 Our present collateral map results showed that collateral circulation was well developed in MMD, except in some patients with acute symptomatic MMD. This may be, in part, because MMD has a chronic course allowing enough time for collaterals to develop.…”

Section: Discussionsupporting

confidence: 51%

“…7 There is also some evidence that supports thromboembolism as the cause of infarction in patients with MMD. 8,9 The present study aimed to explore the mechanism of ischemic stroke in patients with MMD. Thus, we evaluated the infarct pattern and collateral status, using multimodal magnetic resonance (MR) imaging, in patients with MMD.…”

mentioning

confidence: 99%

Infarct Pattern and Collateral Status in Adult Moyamoya Disease

Kim

Son

Yeon

et al. 2017

Stroke

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We prospectively recruited patients >18 years of age with MMD admitted to the tertiary, university stroke center between January 2008 and Background and Purpose-Moyamoya disease (MMD) is a unique cerebrovascular disease characterized by the progressive stenosis of large intracranial arteries and a hazy network of basal collaterals, called moyamoya vessels. Although hemodynamic studies have been applied in MMD patients, the mechanisms of stroke in MMD are still unclear. The present study evaluated the infarct pattern and collateral status using multimodal magnetic resonance imaging in MMD patients. Methods-Adult MMD patients with acute ischemic stroke were prospectively recruited, and infarct pattern on diffusionweighted imaging was evaluated. A collateral flow map, derived from magnetic resonance perfusion-weighted imaging data, was generated through automatic postprocessing, and collateral status was assigned into 3 grades. Transcranial Doppler monitoring was performed to detect microembolic signals in selected patients. Results-A total of 67 hemispheres (31 patients with bilateral and 5 patients with unilateral MMD) were analyzed. Most patients (83.7%) showed embolic pattern and rarely deep (9.3%) or hemodynamic infarct pattern (7.0%) on diffusionweighted imaging. Most cases (86%) showed good collateral status, and few patients with acute infarcts of embolic pattern showed poor collateral status (n=7). One third (31.6%) of patients who underwent transcranial Doppler monitoring showed microembolic signals. Conclusions-In the studied population of adult MMD patients, embolic phenomenon played an important role in ischemic stroke. Therapeutic strategies against thromboembolism, as well as collateral enhancing strategies targeting improvement of hemodynamic status or increased washout of emboli, are warranted.

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“… 35 Recent studies also showed that microembolic signals are associated with recent ischaemic symptoms and progression of arterial lesion, and independently predict cerebral ischaemic events among patients with moyamoya disease. 36 37 European cohort studies also indicated that embolic infarctions are sometimes observed in the beginning of moyamoya disease, and haemodynamic compromise was also shown in patients with high-intensity transient signals. 38 39 Thus, aspirin may help in embolic strokes, not in haemodynamic ischaemia.…”

Section: Discussionmentioning

confidence: 98%

Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

et al. 2016

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ObjectivesTo elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan.DesignRetrospective, multicentre, non-randomised, observational study.SettingNationwide registry data in Japan.ParticipantsA total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan.Main outcome measureWe performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1.ResultsPropensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission.ConclusionsPrehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease.

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Microembolic signals are associated with progression of arterial lesion in Moyamoya disease: A case report

Cited by 11 publications

References 9 publications

Changing ischaemic lesion patterns in adult moyamoya disease

Changing ischaemic lesion patterns in adult moyamoya disease

Infarct Pattern and Collateral Status in Adult Moyamoya Disease

Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

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